The Clinical Research on Emergency Services & Treatments (CREST) Network is a multi-center collaborative network in Kaiser Permanente that encourages, enables, and executes research in emergency medicine. Its goals are to support a cooperative platform for the emergency medicine research community, encourage quality research in emergency medicine, and disseminate evidence-based knowledge to refine current community emergency care standards.
CREST is headquartered at the Kaiser Permanente Division of Research in Oakland, CA. Researchers currently represent the emergency departments of thirteen Kaiser Permanente Northern California medical centers, all of which are community hospitals, including a Level II trauma center. Current research topics include: pulmonary embolism, stroke, atrial fibrillation/flutter, pediatric head trauma, heart failure, chest pain, and knowledge translation via the electronic health record (EHR).
CREST is uniquely positioned with alliances between clinicians, research scientists, programmers, and statisticians. CREST researchers are also working on innovative technologies to improve the practice of emergency medicine, including the development of electronic tools to help physicians risk stratify patients with various clinical conditions in order to optimize patient management.
CREST actively collaborates with clinical researchers throughout the Kaiser Permanente regions nationally and with academic researchers at several universities.
The CREST Network has received federal research funding, as well as funding from the Garfield Memorial Fund, the Kaiser Permanente Innovation Fund for Technology, and the Kaiser Foundation Research Institute. CREST currently is participating in a multi-center federally-funded study of an EHR-integrated clinical decision support tool for the assessment of children with acute abdominal pain. Since its inception, CREST has received over $8 million in funding.
Morris Collen Research Award Winners
“Most research in emergency medicine is conducted at a single hospital or academic center, which may not be generalizable to other emergency departments. CREST conducts community-based research, so it has the potential for broader implications” - Dr. Vinson
About the Award
The Morris F. Collen Research Award recognizes TPMG physicians who make significant contributions to scientific literature, and to the health of our communities.
While most patients visiting the emergency department for chest or abdominal pain do not have a life-threatening condition like a heart attack or appendicitis, determining who is indeed at high risk and in need of urgent management can be a challenging clinical problem for the admitting physician.
To help support such clinical decision-making, a group of TPMG emergency medicine physicians in partnership with the KP Division of Research founded an innovative research network, called CREST, in 2008.
The CREST network comprises 11 clinician researchers who examine disease patterns and treatment outcomes using data from over 1.2 million annual visits to 21 emergency departments across KP Northern California. They then use their findings to refine care protocols and build technologies that optimize patient management.
One of the major successes of the program has been the development of RISTRA, a risk stratification tool for
CREST Video (5 min)
conditions like pulmonary embolism, pediatric appendicitis, and acute coronary syndrome. For pulmonary embolisms, for example, RISTRA helps determine which patients are low risk and can be treated without hospital admission, which has resulted in a 60% increase in the rate of home discharge, with no increase in morbidity or mortality.
CREST researchers have published more than 100 articles in peer-reviewed journals in less than a decade, with subjects ranging from cardiac arrest and pediatric head trauma to ischemic stroke and atrial fibrillation. [source]
Alan S. Go, MD
John Hsu, MD, MBA
Nathan Kuppermann, MD, MPH
Tracy A. Lieu, MD, MPH
Jesse Pines, MD, MBA, MSCE
Donald M. Yealy, MD
Ed Thomas, RN, MBA
Mark Littlewood, MPA, CHE, CPHRM
CREST Medical Centers
Kaiser Permanente Northwest
Kaiser Permanente Colorado
Kaiser Permanente Southern California
Kaiser Permanente Northern California
South San Francisco